Isolated Benign Cerebral Vasculitisと考えられた1例

A Case of What was Regarded as Isolated Benign Cerebral Vasculitis

I．はじめに

　中枢神経系の血管炎は，膠原病などの全身性疾患の部分症状として認められることが多い．しかし，全身性疾患を伴わない中枢神経系に限局する血管炎は稀な疾患である．

　今回われわれは，脳虚血症状で発症し，脳血管撮影上，前大脳動脈に進行性の多発性血管狭窄を認め，ステロイド療法により血管狭窄の改善を確認した脳血管炎と思われる症例を経験した．本例は1978年にSnyderら^21）が報告したisolated benign cerebral vasculitisと考えられ，症例を供覧するとともに文献的考察を加えて報告する．

A 55-year-old man came to us with dysarthria and right hemiparesis. The cerebral angiography showed segmental narrowing and irregularity of the left anter-ior cerebral artery. The patient responded well to corti-costeroid therapy and there was later angiographic evi-dence of healing. After systemic angiitis and central nervous system infection were excluded, the diagnosis of isolated benign cerebral vasculitis was made.

According to past reports, at least 13 patients have been described as having isolated benign cerebral vas-culitis. The common features of isolated benign cere-bral vasculitis are as follows:① benign evolution, ② sensitiveness to corticosteroids,③ absence or mini-mal change of CSF findings,④ angiographic pattern of arteritis,⑤ the most common symptom is headache. We suggest that early corticosteroid therapy is neces-sary in any case of cerebral vasculitis.